Strategic Impact

This project will have impacts in the following six spheres:

Development of tools and standards:

The publication of the WHO guidelines Ensuring Balance in National Policies on Controlled Substances, guidance for accessibility and availability of controlled medicines in 10 languages, will provide an up-to-date and internationally agreed standard for policy and decision makers in Europe and other countries. This publication is an update of the older guidelines Achieving Balance in National Opioids Control Policy. The development and introduction of the International Opioid Consumption Database will allow national governments, international organisations and the general public to access country specific opioid consumption data, which will promote transparency, benchmarking, measuring, monitoring of and comparison between countries on the current status and future improvements in opioid availability in Europe.

National policy-making processes and access to pain medication and substitution treatment:

The outcome of the research undertaken in 12 European countries will result in country reports including concrete recommendations for legislative changes. These reports will be presented to relevant ministries, national organisations and health-care professionals in the 12 countries. This is expected to lead to the adoption of policies allowing for improved access to pain medication and national action in the area of substitution therapy. Better treatment of opioid dependence would contribute to decreased mortality rates, most importantly due to decreased HIV and hepatitis C infections, as well as addressing issues related to the prevention of opioid abuse.

National capacity building:

The six-countries workshops, national follow-up conferences in 12 countries and the review training for national and external lawyers will directly and indirectly build national capacities among civil servants and national lawyers in the area of policies for pain management, palliative care and opioid dependence. In total, 12 civil servants and three attorneys or lawyers will be trained in recognising barriers to opioid access and in analysing controlled drug legislations. Through national symposia and media communications, many more will be informed about the rational use of opioid analgesics and of treatment of heroin dependence with long-acting opioids.

Research collaboration and sharing of experiences in Europe:

This project will stimulate close collaboration, both among the wide range of health-related professionals in the Country Teams, and among the six Country Teams participating in each of the two workshops. The multi-country workshops will ensure that the applied research (situational analysis, policy and legislative reviews and recommendations) and country specific experiences are shared among participating countries. This project represents a first initiative to undertake research into opioid availability at European level and it is likely to stimulate the creation of a network that will last beyond the duration of the project.

Contribution towards the implementation of European policies:

The ATOME project has an impact on the implementation of policies. It is elaborated as part of the overall framework of the WHO Access to Controlled Medication Programme. Moreover, it supports the implementation of the goals of the Council of Europe which has established that palliative care is an inalienable element of a citizen's right to health care and that it is therefore a responsibility of the governments to guarantee that palliative care – including adequate pain treatment - is available to all who need it. The Council of Europe also states that the differences in the availability and quality of palliative care throughout Europe need to be addressed through increased co-operation between countries.

Impact on the patients and populations themselves:

The project is expected to have a positive impact for people in need of pain medication, people with opioid dependence and, related to the latter, populations at risk for attracting HIV and HCV infections. For a wide variety of conditions, patients do not achieve pain relief (analgesia in medical terms) without the use of controlled medicines: for example in cancer pain, HIV neuropathy, diabetic neuropathy, chronic pain, surgery pain (both around and after surgery), traumatic pain and sickle-cell disease. Opioid dependence increases mortality rates due to the poor quality and uncertain strength of heroin on the illicit markets and countries with a high prevalence of untreated illicit opioid use relate to high transmission rates of blood-borne diseases like HIV and HCV, even for the non-opioid dependent part of the population. The ATOME project promotes equal access to opioid medication to millions of patients affected by the above medical conditions in 12 European countries.